Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.

Objective Based on the local anatomic relationship between right sternocleidomastoid and right internal jugular vein,the application value of modified anatomic positioning method in right internal jugular vein puncture during critical cesarean section was discussed.Methods A total of 360 critical patients who underwent elective operation in obstetrics department of our hospital were selected,all of whom received right internal jugular vein puncture. According to different puncture approaches,they were divided into the observation group (punctured by modified anatomic positioning method) and the control group (punctured by traditional middle approach method),with 180 cases in each group. The differences in the success rate of one-time puncture,the overall success rate of puncture and the failure rate of guide wire implantation were compared between the two groups. The incidence of complications such as misplacement into the artery,artery hematoma,hemopneumothorax,arrhythmia and brachial plexus injury were compared in the two groups. Results The success rate of one-time puncture and overall success rate of puncture in the observation group were significantly higher than those in the control group,and the differences were statistically significant (P<0.05). The failure rate of guide wire implantation in the observation group was lower than that in the control group,and the difference was statistically significant (P<0.05). The incidences of misplacement into the artery and artery hematoma in the observation group were significantly lower than those in the control group,and the differences were statistically significant (P<0.05). No complications such as hemopneumothorax,arrhythmia or brachial plexus injury occurred in the two groups. Conclusion Compared with the traditional middle approach method puncture,the modified anatomic positioning method puncture has the advantages of higher puncture success rate,fewer complications and higher safety.

Caspase-8 is a cysteine-aspartate protease widely dis-tributed in cells.As a molecular"switch",caspase-8 is involved in the regulation of various modes of cell death,including apopto-sis,necroptosis and pyroptosis.During cerebral ischemia/reper-fusion,caspase-8 activation is one of the key factors inducing neuronal cell death.Currently there are both specific inhibitors of caspase-8,such as Z-IETD-FMK and Ac-IETD-CHO,as well as a variety of pan-caspase inhibitors,such as z-VAD,Q-VD-OPH,and enricosan.Both animal and cellular experiments have demonstrated that all of these inhibitors attenuate cerebral ische-mia/reperfusion injury,an effect that involves inhibition of caspase-8 activity and reduction of neuronal apoptosis.Clinical-ly,certain drugs for ischemic stroke reduce plasma caspase-8 ac-tivity,suggesting that caspase-8 may be a biomarker for the diag-nosis and prognosis of ischemic stroke.Finding and developing clinically valuable inhibitors around caspase-8 is expected to provide new ideas for new drug development in ischemic stroke.

Caspase-8 is a cysteine-aspartate protease widely dis-tributed in cells.As a molecular"switch",caspase-8 is involved in the regulation of various modes of cell death,including apopto-sis,necroptosis and pyroptosis.During cerebral ischemia/reper-fusion,caspase-8 activation is one of the key factors inducing neuronal cell death.Currently there are both specific inhibitors of caspase-8,such as Z-IETD-FMK and Ac-IETD-CHO,as well as a variety of pan-caspase inhibitors,such as z-VAD,Q-VD-OPH,and enricosan.Both animal and cellular experiments have demonstrated that all of these inhibitors attenuate cerebral ische-mia/reperfusion injury,an effect that involves inhibition of caspase-8 activity and reduction of neuronal apoptosis.Clinical-ly,certain drugs for ischemic stroke reduce plasma caspase-8 ac-tivity,suggesting that caspase-8 may be a biomarker for the diag-nosis and prognosis of ischemic stroke.Finding and developing clinically valuable inhibitors around caspase-8 is expected to provide new ideas for new drug development in ischemic stroke.

Objective Based on the local anatomic relationship between right sternocleidomastoid and right internal jugular vein,the application value of modified anatomic positioning method in right internal jugular vein puncture during critical cesarean section was discussed.Methods A total of 360 critical patients who underwent elective operation in obstetrics department of our hospital were selected,all of whom received right internal jugular vein puncture. According to different puncture approaches,they were divided into the observation group (punctured by modified anatomic positioning method) and the control group (punctured by traditional middle approach method),with 180 cases in each group. The differences in the success rate of one-time puncture,the overall success rate of puncture and the failure rate of guide wire implantation were compared between the two groups. The incidence of complications such as misplacement into the artery,artery hematoma,hemopneumothorax,arrhythmia and brachial plexus injury were compared in the two groups. Results The success rate of one-time puncture and overall success rate of puncture in the observation group were significantly higher than those in the control group,and the differences were statistically significant (P<0.05). The failure rate of guide wire implantation in the observation group was lower than that in the control group,and the difference was statistically significant (P<0.05). The incidences of misplacement into the artery and artery hematoma in the observation group were significantly lower than those in the control group,and the differences were statistically significant (P<0.05). No complications such as hemopneumothorax,arrhythmia or brachial plexus injury occurred in the two groups. Conclusion Compared with the traditional middle approach method puncture,the modified anatomic positioning method puncture has the advantages of higher puncture success rate,fewer complications and higher safety.

Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.

Objective: Using Meta-analysis to evaluate the vaccine effectiveness of 13-valent pneumococcal conjugate vaccine (PCV13) against invasive Streptococcus pneumoniae disease (IPD) caused by serotype 19A in children <5 years old. Methods: "Streptococcus pneumoniae infection""invasive pneumococcal disease""13-valent pneumococcal polysaccharide conjugate vaccine""PCV13""effectiveness""infant""child" and related terms were searched from China National Knowledge Infrastructure (CNKI), WANFANG DATA, PubMed, SCOPUS and Web of science with no limited on language, region and research institution. The retrieval time was limited from January 2010 to February 2023 and cohort study, case-control study and randomized controlled trial were included. Data were extracted from eligible studies by two independent reviewers, and after study quality assessment by NOS scale, Meta-analysis was completed using Stata 16.0 software. Results: A total of 2 340 related literatures were searched, and 10 literatures were finally included, including 5 case-control studies and 5 indirect cohort studies, which showed good literature quality. The vaccine effectiveness against serotype 19A IPD of PCV13 in children was 83.91% (95%CI: 78.92%-88.89%), and the subgroup analysis (P=0.240) showed there was no significant difference among the case-control study (VE=87.34%, 95%CI:79.74%-94.94%) and the indirect cohort study (VE=81.30%, 95%CI:74.69%-87.92%). The funnel plot and Egger test suggested that the possibility of publication bias was small. Conclusion: The present evidence indicates that PCV13 has a good vaccine effectiveness against serotype 19A IPD in children, and it is recommended to further increase the vaccination rate of PCV13 to reduce the disease burden of IPD in children <5 years old.
Child ; Humans ; Child, Preschool ; Case-Control Studies ; Cohort Studies ; Serogroup ; Vaccines, Conjugate/therapeutic use* ; China ; Pneumococcal Infections/prevention & control*

Objective: Using Meta-analysis to evaluate the vaccine effectiveness of 13-valent pneumococcal conjugate vaccine (PCV13) against invasive Streptococcus pneumoniae disease (IPD) caused by serotype 19A in children <5 years old. Methods: "Streptococcus pneumoniae infection""invasive pneumococcal disease""13-valent pneumococcal polysaccharide conjugate vaccine""PCV13""effectiveness""infant""child" and related terms were searched from China National Knowledge Infrastructure (CNKI), WANFANG DATA, PubMed, SCOPUS and Web of science with no limited on language, region and research institution. The retrieval time was limited from January 2010 to February 2023 and cohort study, case-control study and randomized controlled trial were included. Data were extracted from eligible studies by two independent reviewers, and after study quality assessment by NOS scale, Meta-analysis was completed using Stata 16.0 software. Results: A total of 2 340 related literatures were searched, and 10 literatures were finally included, including 5 case-control studies and 5 indirect cohort studies, which showed good literature quality. The vaccine effectiveness against serotype 19A IPD of PCV13 in children was 83.91% (95%CI: 78.92%-88.89%), and the subgroup analysis (P=0.240) showed there was no significant difference among the case-control study (VE=87.34%, 95%CI:79.74%-94.94%) and the indirect cohort study (VE=81.30%, 95%CI:74.69%-87.92%). The funnel plot and Egger test suggested that the possibility of publication bias was small. Conclusion: The present evidence indicates that PCV13 has a good vaccine effectiveness against serotype 19A IPD in children, and it is recommended to further increase the vaccination rate of PCV13 to reduce the disease burden of IPD in children <5 years old.
Child ; Humans ; Child, Preschool ; Case-Control Studies ; Cohort Studies ; Serogroup ; Vaccines, Conjugate/therapeutic use* ; China ; Pneumococcal Infections/prevention & control*

Objective: To investigate the incidence of adverse events following immunization (AEFI) of human papillomavirus (HPV) vaccines in Hangzhou City from 2017 to 2021, so as to provide insights into safety monitoring and evaluation for HPV vaccines. Methods: The AEFI caused by immunization of bivalent (HPV2), quadrivalent (HPV4) and nonavalent HPV vaccines (HPV9) reported in Hangzhou City from 2017 to 2021 were captured from the AEFI Surveillance Module of Chinese Disease Control and Prevention Information System, and HPV vaccination data were captured from the Zhejiang Municipal Immunization Information Management System. The incidence, temporal distributions and clinical symptoms of AEFI were analyzed. Results: Totally 922 310 doses of HPV vaccines were immunized in Hangzhou City from 2017 to 2021, and 232 cases with AEFI were reported, with an overall incidence rate of 25.15/105 doses. The reported incidence rates of AEFI caused by HPV2, HPV4 and HPV9 vaccination were 31.13/105 doses, 25.93/105 doses and 22.01/105 doses, respectively. General reactions and abnormal reactions were predominant AEFI, and the reported incidence rates of general reactions and abnormal reactions were 21.58/105 doses and 2.60/105 dose, respectively. AEFI predominantly occurred 0 to 1 day post-immunization (165 cases, 71.12%), and the main clinical symptoms included local swelling of injection sites, hard tubercle and fever, with reported incidence rates of 10.30/105 doses, 5.96/105 doses and 6.18/105 doses, respectively. Conclusions Low incidence of AEFI was reported following HPV vaccination in Hangzhou City from 2017 to 2021, and all AEFI were mild. The safety of HPV2, HPV4 and HPV9 remains high.

Objective: To explore the method and effect of endoscopic assisted functional rhinoplasty for patients with deviated nose and deviated nasal septum, which achieve correction of nasal morphology and ventilation dysfunction. Methods: The clinical data of 226 patients with deviated nose and deviated nasal septum from June 2009 to February 2022 who were treated by endoscopic assisted functional rhinoplasty in the Affiliated Hospital of Qingdao University were analyzed retrospectively. There were 174 males and 52 females, with the age ranging from 7 to 67 years old. The effect was evaluated by subjective and objective evaluation methods. SPSS 27.0 software was used for statistical analysis. Results: All patients were followed up for 6 to 24 months, 174 cases were cured (174/226, 76.99%), 52 cases were effective (52/226, 23.01%), and the total effective rate was 100% (226/226). The difference between preoperative and postoperative facial appearance deviation was statistically significant ((6.84±2.25)mm vs (1.82±1.05)mm, t=38.94, P<0.001), and the nasal ventilation function of all patients was improved. Conclusions: Endoscopic assisted functional rhinoplasty for the patients with deviated nose combined with deviated nasal septum has the advantages of clear surgical field, fewer complications, and good result. It can achieve the purpose of simultaneous correction of nasal and ventilation dysfunction, which is recommended for popularizing in clinical application.